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How to Train for a Utilization Review for an RN

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Utilization review nurses play an important role in today's health care system. They track patient cases and treatments to make sure medical facilities are giving necessary treatment within patients' health plan guidelines. The work requires a nurse's trained clinical judgment and knowledge, but involves no direct patient care. So, when a nurse wants to make the transition to utilization review, both employers and nurses prefer that she receives training.

Find out if your employer offers in-house training on utilization review. Many insurance companies and hospitals like to promote from within on utilization review positions. Case management nurses already within an organization may have an easy time transitioning into a UR role with little extra training. Also, organizations often prefer nurses to learn to do the work the way the organization wants it done.

Take utilization review courses from a trade association such as the American Nursing Association or the Utilization Review Accreditation Commission. Both organizations play a part in setting nursing standards within the specialty and offer courses that not only train, but are worth continuing education credits nurses can use to maintain their licenses.

Investigate utilization review courses at nearby community colleges, vocational colleges and universities with nursing programs. Some offer individual classes on the subject that licensed RN's can take through extension and continuing education offerings.

Enroll in a certification course if you want to claim a formal specialty in utilization review. For example, the American Board of Quality Assurance and Utilization Management Physicians offers a Health Care Quality and Management Certification for both physicians and nurses.

Take private, online courses from one of the many online nursing continuing education providers. While these programs lack hands-on training and being able to sit with an instructor, they allow nurses to more easily fit training into their busy lives and schedules.


Eric Feigenbaum started his career in print journalism, becoming editor-in-chief of "The Daily" of the University of Washington during college and afterward working at two major newspapers. He later did many print and Web projects including re-brandings for major companies and catalog production.